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Hybrid Breast Augmentation

What is it?
A hybrid breast augmentation combines the use of breast implants with the technique of lipofilling, which is the use of one's own fat tissue that is taken from the body and processed so that it can be injected.
This technique allows you to:
- Choose smaller implants and achieve the desired volume in combination with lipofilling.
- In addition to increasing breast volume, be able to correct certain breast irregularities (even in cases where there are retracting scars and depression caused by a previous surgery)
- Improve shape in tubular or tuberous breasts, as implants alone are often unable to correct shape and contour irregularities.
- Increase implant coverage ensuring a more natural result.
mastoplastica hybrida
Why is the procedure performed?
It is a suitable procedure for all patients who want to increase the volume of their breasts but:
- Desire a small implant that is less noticeable to touch.
- Correct breast irregularities after surgery.
- Asymmetries that cannot be corrected with the help of an implant alone.
- In the case of tuberous and tubular breasts.
- In the case of little tissue covering the implants.

In a hybrid breast augmentation, fat does not have a filling purpose but improves the final result.
What needs to be done before surgery?
Hybrid augmentation mammoplasty is not suitable for everyone: it is reserved for women who have the correct indication and some accumulation of fat necessary to perform the surgery (although most of the time it is not necessary to harvest large amounts of fat).
How is the surgery performed?
The first phase of the surgery involves harvesting fat from specific areas of the body and preparing it for injection later on. Then mastoplasty and placement of the chosen implants are performed, surgical accesses are closed with fat, and the lipofilling technique is used to increase breast volume and/or reshape breast irregularities. The procedure is performed under general anesthesia and lasts about 2 to 2.5 hours. The surgical access is the same as that of a standard breast augmentation; small cannulas are used to harvest and infiltrate the fat, which will not leave any marks over time. Finally, a compression bandage is applied, which once removed, is replaced by a sports bra.
What happens after the operation?
About 3 days after the operation, the compression dressing is removed and replaced with an elastic sports bra, which must be worn for about 60 days. In addition, a compression garment should be worn in the areas where fat was harvested. During the first few days following the operation, absolute rest and restriction of movement, particularly of the upper limbs, is recommended. In the early postoperative phase, feelings of swelling, stiffness, and mild pain in the breasts is normal. After 7 to 10 days, work activity can be resumed, and after about 30 days, exercise activity as well.
During the initial postoperative days, the presence of mild pain, swelling, redness and bruising of the treated area is normal. Postoperative discomfort can be controlled with normal pain relievers and anti-inflammatories. Before and after surgery, certain medications such as aspirin should not be used.
Residual scars are about 4-7 cm in length and are barely visible, either in the breast sulcus or at the peri-areolar level. Liposuction scars are only a few millimeters and are therefore imperceptible or otherwise of little aesthetic significance.
The result of the surgery depends on several factors, such as the patient's starting clinical condition, healing capacity, and adherence to the postoperative indications given by the surgeon: avoid inappropriate movements, refrain from sun exposure until the scars are completely stabilized. The final profile will be visible after about a year, but the results and benefits will be appreciable right away. It must be said, however, that some of the infiltrated fat will be lost over time (about 30%) and in cases of very athletic people this percentage may be higher.
What are the possible risks?
Complications of the surgery are rare, but possible: hematoma and bleeding, infection, delayed healing of the surgical wound, hypertrophic scarring, change in skin sensitivity.
Possible complications related to prosthetic breast implantation are capsular contracture and prosthetic rupture. The causes of these complications are still not entirely clear, and there are numerous studies on the subject. Capsular contracture is a predictable and very common complication, which consists of the formation of an overly rigid periprosthetic capsule that dislocates the implant causing breast asymmetry. There are various degrees of contracture and depending on the severity, the most appropriate treatment is carried out. In more severe cases, surgical revision with possible capsulotomy and implant replacement is required. The use of appropriate precautions and new-generation, high-quality implants greatly reduces the incidence of this complication. Breast implant rupture, a rarer complication, results in pain and breast asymmetry and requires surgical revision with implant site cleaning and implant replacement.
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Dr. Luca Piombino
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